MGMA SEEKS REBILLING CLARIFICATION SHOULD MEDICARE CUT BE RETROACTIVELY ADDRESSED

MGMA sent a letter to the Centers for Medicare and Medicaid Services (CMS) and the Office of Inspector General (OIG) asking for rebilling clarification should Congress retroactively address the 3.37% Medicare conversion factor cut. Specifically, the letter requests guidance to ensure medical groups do not violate the beneficiary inducement statute if they choose to waive small patient balances that could result from a retroactive payment increase.

Congress has returned from its holiday recess with only a few weeks before a partial government shutdown on Jan. 19 if funding for certain government agencies is not extended. Addressing the 3.37% cut to the conversion factor remains MGMA’s top priority.

ONC PUBLISHES FINAL HTI-1 RULE

The Office of the National Coordinator for Health Information Technology (ONC) published its final rule to advance health information technology (IT) and algorithm transparency (HTI-1) in the Federal Register after announcing it at the end of last year. The rule touches on many topics related to health IT such as updating the ONC health IT certification program, establishing transparency requirements for artificial intelligence and predictive algorithms included in certified health IT, revising certain information blocking definitions and exceptions, and more. MGMA provided comments on the proposed version of the rule last year.

HAVE YOUR PHYSICIANS RECEIVED A REQUEST FOR PATIENT-CARE HOURS INFORMATION FROM AMA/MATHEMATICA?

The physicians in your practice may have received a request from Mathematica to participate in a short patient-care hours study. If they have, please encourage them to participate. The Medicare physician payment schedule, which is used by many other payers, relies on 2006 cost information to develop practice expense relative values, the Medicare Economic Index and resulting physician payments. Mathematica is collecting the data needed to calculate updated practice expenses per hour of patient care by physician specialty. More information may be found here.